kites and bicycles

The sky fills up with kites on Saturday. During my run with Yanti (mother) we passed throngs of boys whose eyes were fixed somewhere hundreds of feet in the air. Other boys riding bicycles had wedged empty plastic cups beneath their cantilever brakes so that the bikes roared like little motorcycles when the boys peddled. Many of these children are the sons and daughters of former leprosy patients who now live in the settlement. 

 
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Sitanala Staff Aerobics

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I woke up early to attend “Friday Hospital Staff Aerobics”. The staff have organized a weekly exercise routine in which a trainer brings a small stage, enormous amps and speakers,  a CD with the best combination of 80s, 90, and today. Mostly ladies attend. They dress in full “batik” with hijab despite the heat and movement.  Male staff also join in although their movements are clumsier and they have trouble keeping up with the steps. The instructor leads the group in dance routines that they have clearly done before because they are experts, all moving together to the beat, kicking feet out, pumping arms, curling abdomens. I joined in, struggling to keep up. I couldn’t stop laughing. The idea of a whole hospital staff exercise routine anywhere else in the world sounds impossible, but here in this country of fun-loving, light-hearted people, it is the best idea. I had so much fun with the ladies (and three determined gentlemen) that it hardly felt like exercise at all. Afterwards I could tell we had moved quite a lot because our clothes were sopping wet and our faces red. They gave me hot sweet lentil soup (an interesting choice after a hot work out) but it was actually delicious and exactly what my body needed. I am excited to attend all the aerobics classes at Sitanala.

That afternoon I got to see my favorite patient. He is a very tiny man and his wife is a very large woman. They are sweet together. August (that is his name), invited me to the leprosy settlement. He wanted me to come to his home where he will show me around. He told me there is no stigma there. No problem. You can have any deformity and you will still be accepted. I can’t wait to visit him at his home. I just have to think of the right sort of gift to bring… ideas?

In the evening we piled into the minivan to go to the supermarket where we could buy all ingredients necessary for traditional pizza. I was excited to share something with this family that has given me so much. The supermarket pretty much blew my mind. It is nestled deep inside a posh and intoxicating super mall. There are designer shops glittering behind glass, technology whizzing and whirring and flashing, people people everywhere not looking at each other, but having eyes only for the things that pop out of advertisements capturing everyone’s attention. There was too much to see. My brain felt overwhelmed. Finally we arrived at the super supermarket. It was sparkling just like the rest of the mall and stocked with imported olive oil, tomato sauce, flour, mozzarella cheese, and all other worldly delights. We got all lost in the supermarket and ended up getting home too late for pizza making.

Director

The director of Sitanala Hospital is the nicest sweetest woman. She sat me down in her enormous office on the top floor  of the hospital (pent house). I looked around at the puffy couches, desks, pictures hanging on the wall, and surveillance monitors! I was so distracted by these footages of people —patients, staff, attendants moving around in the wards, lobby, hallways, elevator… I wondered if she had seen me touring around the hospital in her glass tower with peepholes into all departments. But meeting her and observing her gentle and warm demeanor, I didn’t feel threatened by the surveillance. She keeps an eye out for her patients and staff and that is a good thing.  She put her hand on my shoulder when I was getting up to leave and told me we would see each other July 4th for the hospital anniversary celebration.

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Amputation

 

I woke up early after a night of little sleep. I had made myself wake up several times because there was a woman in labor. I wanted to see and maybe assist in the birth. But finally, at 4 AM she was sent to the emergency room. I went back to sleep nervously thinking about her and her baby. In the morning I went to meet Dr. Prima in the rehabilitation center. She is my contact person from months ago when I decided I wanted to see Indonesia. It was wonderful to meet her and work out my schedule for the month that I will spend at Sitanala Hospitall. I will be assisting in wound care, operation theater, out patient department (OPD new cases), charting and screening (also new cases), ward rounds, statistical analysis, physiotherapy, occupational therapy, and rehabilitation. I am particularly excited about the rehabilitation because apparently former leprosy patients have a vocational training center where they sew, carve, paint, weave, etc. I would love to spend a day making art with them and maybe teaching about some of the crafts that the former leprosy patients make in the KRMEF village in Nepal (http://krmecofoundation.org/). Dr. Prima was so kind and gave me a beautiful red necklace! I need to think of gifts for all of my friends here who keep giving me things and beyond things!

I went with Dr. Yousuf to the canteen for fruit smoothie snack. Delicious mango kiwi smoothie! Then we tiptoed into the surgical theater. Shoes off. Stepping into the break room which is located between the entrance hall and the theater we were greeted by giggling surgeons playing chess on the floor. We had walked in on a check mate. “Perfect timing” one of them said, beckoning me to the floor. I sat and positioned my pieces. I thought about the last time I had played chess. Must have been over a year ago. The only chess instance that stands out in my memory is when I spent New Year’s Eve in a little cabin in the Blue Ridge Mountains playing chess and drinking wine. That must have been at least four years ago though.  I forgot how much chess pulls your mind into the board and into the future. Anticipating: if he moves here, then I move there, then he moves here, I could go here or here…. then check mate! I won! But I really can’t take credit because a little surgeon dressed in scrubs kept whacking my arm whenever I was about to do something stupid.

After chess the nurse handed me fresh scrubs, a mask, and cap and pointed to the dressing room. I changed, feeling a little bit queazy about the imminent amputation. That is my least favorite surgery. To have a piece of your body taken off permanently like an arm or a leg is tragic to me. I get a bit emotional. However, the patient wanted this procedure because his foot was no longer viable. He would never walk on it again anyway. At first it was hard for me to watch his body being mutilated, but after some time I became interested in the many layers of facia, nerves, vessels, muscle, and bone that were being displayed in perfect cross section. The surgeon pointed out a grotesquely enlarged posterior tibial nerve (infected with M. leprae). The patient was awake and I kept walking around the table to check on him. I told him he was a very brave man and Dr. Yousuf translated. The patient beamed and stuck his thumb in the air. Finally, a muscle flap was created over the bone end, a drain inserted, and the tissue and skin sutured closed.

I visited the patient the following day and he seemed to be doing very well. He gave me permission to post these pictures and requested print outs for his own records.

Night Market and Gamelan

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We walked as a family through the leprosy settlement in Sitanala toward the night market. It is a small market, about the size of two basketball courts. There is a kiddy train and ferris wheel. There are clothing shops and traditional food stalls. Patients, staff, and outside people all mingle among fruit stands and boiling pots of oil. I bought apples and eggs to share. We walked back to the house to drop Yantina and the children off. Then Cecep and I rode the scooter to the Gamelan rehearsal. It is in a school classroom located within the hospital campus. The room is packed with enormous ancient instruments, filled with smoke from the musicians’ cloves and Djarum, and lit by the warm stage lights illuminating the puppet show. I sat mesmerized by the music. Gamelan transports you gently into an altered state of consciousness. The music is both repetitive and innovative/exploratory. They use a secret number system code to read music. The numbers range from 1-7, indicating do, re, me, fa, sol, la, ci. They write reams of these numbers and play 40 minute songs without taking a break. I learned how to play an instrument made out or resonant gold pots. I also learned how to play a bamboo instrument and this I got to play in one of the songs. 32122121313.. . I was particularly drawn to the Wayang master (puppeteer). He brought the intricate Indonesian puppets to life, seamlessly moving their arms, heads, and giving them voice. As their shadows danced across the curtain,  I wondered about the historical importance of the Wayang. They are part of an ancient Indonesian tradition. The earliest record of the Wayang dates back to the 800s, a time when ancestral spirits cloaked the communities in stories, art, theater, dance, and superstition. Semar is believed to be the ancient spirit of Java and appears in many Wayang stories. I think he was there tonight in the story, but it was in Javanese so I may have misunderstood. (I read about Indonesian art and history from this website: http://education.asianart.org/ and I highly recommend checking it out).

Wednesday Post

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Cecep took me to the post office early in the morning so that I can finally send these letters that I have been writing since the beginning of my year in India. Seriously, I have carried them from country to country, collected stamps, envelopes, even addresses, but for some reason I just never sent them. Now I was determined that these letters arrive at their respective houses before I do (which is just over one month away!). The post office was unbelievably packed with people. They formed lines that snaked through the parking lot. What are they waiting for I asked? Certainly it couldn’t be post marks. “Money” Cecep told me. The government gives economically disadvantaged families 150,000 ru/ month. That is about $15/month, but it goes a long way.

I played pingpong with patients and staff in the afternoon. I am improving! I still have to learn the slam though.

Family Dinner

Cecep, Yanti, and the kids have accepted me into their family warmly. They noticed that I am vegetarian so they took me out to an all vegetarian restaurant called “Visual Veggie”. It was Chinese food. Even though we cannot have philosophical discussions about the human condition across the language barrier (not that I always want to talk about pretentious things either, but just as an example) I really enjoy our broken English conversations and non-verbal communication.